• Title/Summary/Keyword: spinal pain

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Role of microglial activation on neuronal excitability in rat substantia gelatinosa

  • Park, Areum;Chun, Sang Woo
    • International Journal of Oral Biology
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    • v.45 no.4
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    • pp.225-231
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    • 2020
  • Glial cells, including astrocytes and microglia, interact closely with neurons and modulate pain transmission, particularly under pathological conditions. In this study, we examined the excitability of substantia gelatinosa (SG) neurons of the spinal dorsal horn using a patch clamp recording to investigate the roles of microglial activation in the nociceptive processes of rats. We used xanthine/xanthine oxidase (X/XO), a generator of superoxide anion (O2·-), to induce a pathological pain condition. X/XO treatment induced an inward current and membrane depolarization. The inward current was significantly inhibited by minocycline, a microglial inhibitor, and fluorocitrate, an astrocyte inhibitor. To examine whether toll-like receptor 4 (TLR4) in microglia was involved in the inward current, we used lipopolysaccharide (LPS), a highly specific TLR4 agonist. The LPS induced inward current, which was decreased by pretreatment with Tak-242, a TLR4-specific inhibitor, and phenyl N-t-butylnitrone, a reactive oxygen species scavenger. The X/XO-induced inward current was also inhibited by pretreatment with Tak-242. These results indicate that the X/XO-induced inward current of SG neurons occurs through activation of TLR4 in microglial cells, suggesting that neuroglial cells modulate the nociceptive process through central sensitization.

Assessment of Lumbar Spine Kinematics by Posterior-to-Anterior Mobilization

  • Oh, Kang O;Lee, Sang-Yeol
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.450-456
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    • 2021
  • Objective: Studies confirming the lumber spine kinematics of direct or indirect segmental mobility under the application of joint mobilization, which induces passive force on the spine, are insufficient.Therefore, this study aims to obtain the underlying clinical data by identifying direct or indirect segmental mobility produced by Maitland's PA mobilization technique. Design: Randomized controlled trial design. Methods: Thirty subjects with no back pain participated in this study. X-ray testing equipment (SIG-40-525, Ecoray Inc., Korea) was used to verify the segmented movement of their lumbar. Joint mobilization was performed by physiotherapists with more than 10 years of experience in prescription therapy, and radiography was performed once without PA joint mobilization and once without the mobilization for comparing the lumbar vertebrae before and after the mobilization. The radiographs taken were analyzed using the picture archiving and communication system (PACS) program to measure the spinal displacement, intervertebral height, intervertebral angle, and lumbar lordosis angle. Results: Significant differences were observed in the lumbar displacement, intervertebral angle, and lumbar lordosis angle in all lumbar vertebrae before and after the mobilization. The intervertebral height indicated significant differences in all ventral vertebrae and only in L3-L4 and L4-L5 in dorsal vertebrae. Conclusions: This study suggests that the segmental mobility produced through indirect approaches plays an important role in inducing therapeutic effects in patients with back pain.

Complex Acupuncture Treatment for Cervical Ossification of Posterior Longitudinal Ligament: Case Report of Two Patients

  • Jae Hyung Kim;Ga Young Choi;Sang Ha Woo;Jung Hee Lee;Hyun Jong Lee;Jae Soo Kim
    • Journal of Acupuncture Research
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    • v.40 no.3
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    • pp.265-271
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    • 2023
  • Ossification of the posterior longitudinal ligament (OPLL) is a disease that narrows the spinal canal, causing neurological symptoms. To date, there have been several reports on traditional Korean medicine treatments for OPLL; however, there is no study on complex acupuncture treatment. Herein, we report 2 cases of cervical OPLL involving cervical pain, upper limb radiating pain, and hypoesthesia. The patients were diagnosed using C-spine computed tomography and did not receive any treatment at any other hospital. The patients were treated with acupuncture treatments, including electroacupuncture, pharmacopuncture, and acupotomy, at Daegu Korean Medicine Hospital at Daegu Haany University. The results were assessed using the visual analog scale, neck disability index, and Japanese Orthopedic Association scores, and the results indicated an improvement in the symptoms. Thus, this study demonstrated that complex acupuncture treatment may be helpful for treating cervical OPLL and improving the quality of life.

Surgical Treatment for Metastatic Spinal Tumor (전이성 척추 종양의 수술적 치료)

  • Han, Chung-Soo;Kim, Ki-Tack;Soh, Jae-Ho;Lee, Jung-Hee;Shin, Dong-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.1-9
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    • 2000
  • Purpose : Spine is one of the most common sites of the metastatic bone tumors. Conservative management such as chemotherapy or radiotherapy has been preferred in most cases. However, the neurologic deficit has not been usually improved, and the quality of life was poor. The purpose of this study was to show the efficacy of the surgical treatments for metastatic spinal tumors in terms of postoperative improvements of neurologic deficit and survival time. Materials and Methods : Authors have reviewed the literatures and analyzed 14 patients of metastatic spinal tumors who were received operative treatments between August 1991 and June 1999 at the our department of orthopaedic surgery. Results : The most frequent primary tumor was breast cancer in women and lung cancer in men. The thoracic region was the most common site. There was a preponderance of females over males, and the age ranged between 4th and 8th decade. The indications of surgical treatment comprised instability, progressive neurologic findings, resistance to radiotherapy, pathological fracture, long life expectancy( >6weeks), isolated metastasis and need for pathological diagnosis. The degree of preoperative neurological deficit might influence on the improvement of clinical symptoms after surgery. Conclusion : The surgical treatment reduced the neurological deficit and pain regardless of the operative methods. In the early stage of neurological deficit, the surgical treatment was important for better prognosis. Recently early active operative treatment was performed for metastatic spinal tumor to minimize the intractable pain and to prevent the progression of the neurologic deficit. Early intervention can improve the quality of life and long term survival.

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A Study on the Changes of the Synaptic Structures in the Interpolar Part of Spinal Trigeminal Nucleus of Rat during Aging (연령증가에 따른 흰쥐 삼차신경척수핵 중간부분에서의 신경연접구조의 변화에 관한 연구)

  • Kim, Myung-Kook;Kim, Cheol-We;Paik, Ki-Suk;Lim, Bum-Soon
    • Applied Microscopy
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    • v.28 no.3
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    • pp.255-262
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    • 1998
  • This study was performed to observe the morphological changes of the synaptic structures in the interpolar part of the spinal trigeminal nucleus of rat during aging. Transmission electron microscopy has been used to determine the r)umber of synapses, length of postsynaptic densities, number and area of axon terminals. Sprague-Dawley rat 3, 12, 24 and 36 months of age were used in this study. 1. The number of synapses was 51.7, 43.1, 28.4 and 16.8 in the 3, 12, 24 and 36 months of age respectively. Therefore, the number of synapses decreased gradually with age, but decreased significantly in the 24 and 36 months. 2. The length of postsynaptic densities was $30.2{\mu}m,\;23.6{\mu}m,\;10.4{\mu}m\;and\;4.9{\mu}m$ in the 3, 12, 24 and 36 months of age respectively. Therefore, the length of postsynaptic densities decreased gradually with age, but decreased significantly in the 24 and 36months. 3. The number of axon terminals was 84.3, 73.7, 51.4 and 26.6 in the 3, 12, 24 and 36 months of age respectively. Therefore, the number of axon terminals decreased gradually with age, but decreased significantly in the 24 and 36months. 4. The area of axon terminals was $76.1{\mu}m^2,\;64.1{\mu}m^2,\;29.9{\mu}m^2\;and\;13.8{\mu}m^2$ in the 3, 12, 24 and 36 months of age respectively. Therefore, the area of axon terminals decreased gradilally with age, but decreased significantly in the 24 and 36 months. The results suggest that there are the changes of the synaptic structures in the interpolar part of spinal trigeminal nucleus of rat during aging. These changes nay be concerned to the decreased function of mediating pain and temperature sensation in the face and oral cavity during aging.

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Effect of Dietary Calcium on Spinal Bone Fusion in an Ovariectomized Rat Model

  • Cho, Jae-Hoon;Cho, Dae-Chul;Yu, Song-Hee;Jeon, Young-Hoon;Sung, Joo-Kyung;Kim, Kyoung-Tae
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.281-287
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    • 2012
  • Objective : To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. Methods : Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. Results : The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group ($71.80{\pm}8.06mm^3$) than in controls ($35.34{\pm}8.24mm^3$) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks ($610.08{\pm}10.41$ vs. $551.61{\pm}12.34$ ng/mL) and 8 weeks ($552.05{\pm}19.67$ vs. $502.98{\pm}22.76$ ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks ($77.07{\pm}12.57$ vs. $101.75{\pm}7.20$ ng/mL) and 8 weeks ($69.58{\pm}2.45$ vs. $77.15{\pm}4.10$ ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). Conclusion : Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.

A Study on the Social Adaptation of Spinal Cord Injured Patients (척수 손상자의 사회 적응에 관한 연구)

  • Lee, Dong-Soon;Song, In-Young
    • Journal of Korean Physical Therapy Science
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    • v.4 no.2
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    • pp.405-419
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    • 1997
  • This research has been conducted to provide the spinal cord injured patients with comprehensive necessity of and backup data for their rehabilitation in the community and make the aware of importance of overall community support to patients. The data was collected through questionnaire made to 83 patients charged to general hospital in Jeonbuk Province between 1 and 31 March 1997 to analyse the patients ability on activities of daily living through the research on general characteristics and Modified Barthel Index(MBI). As a result the outcome of the research was as follows : 1. Sexual distribution represented that 57 male (68.7%) and 26 female(31.3%) and in the age distribution majority group was 36 thirties (43.4 %) most active in social activities. 2. Analysis on occupation of patients showed majority group was in technicians, 21 people representing 25.4 % and the major cause of injury was traffic accident, 45people representing 54.2%, fall down, 17 people representing 20.5% and industrial accident, 13 people representing 15.7%, respectively. 3. In the multiple choice questionnaire on complications, the rate of appealing pain was highest and spasticity, pressure sore, contracture, depression which restrict the patients from activities of daily living ability were also appeared. 4. The theoretical points in MBI Should lie between 1 and 115 and the average point be 58 but the average point of the MBI among 83 patients was 63. 5. The MBI point by the level of injured represented statistically critical difference(P<0.001) and the MBI points tested by Duncan's Multiple Area Testing in lumbar(80.1) and in thoracic (65.8) represented critically higher than the one in cervical(42.5). 6. In the distribution of the method of Urination after spine injury, the intermittent catheterization represented highest numbar of 34(41.1 %). Testing by Duncan's Multiple Area Testing, as we found the critical difference in the analysis on MBI points(P<0.001), the point in independent self voiding patients ($90.87{\pm}29.34$) was higher than the one in other self voiding patients(P<0.05). 7. In th category of social activities after spine injury, the number of people classified in others, 41 people representing 49.5% was highest and in the MBI points of the spinal cord injured people in religious activity, hobby activity, private club, occupation was critically higher than the people classified in miscellancous(P<0.01) who are the spinal cord injured people and mostly depend on their family's assistance at home in their daily activities.

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Alterations of c-Fos mRNA Expression in Hypothalamic-Pituitary-Adrenal Axis and Various Brain Regions Induced by Intrathecal Single and Repeated Substance P Administrations in Mice

  • Choi, Seong-Soo;Lee, Han-Kyu;Shim, Eon-Jeong;Kwon, Min-Soo;Seo, Young-Jun;Lee, Jin-Young;Suh, Hong-Won
    • Archives of Pharmacal Research
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    • v.27 no.8
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    • pp.863-866
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    • 2004
  • The effect of substance P (Sub P) injected intrathecally (I.t.) on c-fos mRNA expression in vari-ous tissues was examined in the present study. We found that a single administration of Sub P(0.5 nM) caused an increase of the c-fos mRNA level in the hypothalamic-pituitary-adrenal(HPA) axis, hippocampus, and spinal cord. The time-course study showed that c-fos mRNA level was maximal at 10 min and began to decrease 30 min after the Sub P injection in all tis-sues, and the Sub P-induced increase of the c-fos mRNA level was returned to the control level 1 h after the injection. The kinetics of the c-fos mRNA expression in mice that were repeatedly injected with Sub P (every 30 min interval up to 4 times) were different in the HPA axis, hippocampus, and spinal cord. The increased c-fos mRNA level in the hypothalamus and the spinal cord induced by I.t. injected Sub P remained at a high level. In the pituitary gland, adrenal gland, and hippocampus, the increased level of c-fos mRNA expression gradually returned to the control level during the repeated substance P injections up to 4 times. Our results suggest that spinally injected Sub P-induced pain stress increases c-fos mRNA expres-sion in the spinal cord, hippocampus, and HPA axis. In mice repeatedly injected with Sub P, the kinetics of c-fos mRNA appear to be different varied from tissue to tissue.

Effects of the Inspiratory Muscle Strengthening Training on the Respiratory Functions and the Quality of Life in Patients with Cervical Spinal Cord Injury Patients (들숨근 훈련이 경수손상환자의 호흡기능 및 삶의 질에 미치는 영향)

  • Shim, Yu-Jin;Moon, Ok-Kon;Choi, Wan-Suk;Kim, Bo-Kyung
    • The Journal of the Korea institute of electronic communication sciences
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    • v.8 no.11
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    • pp.1785-1792
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    • 2013
  • For patients suffering from spinal cord injuries, both of the possibility of having complications with the respiratory system and the related fatal rate are still high, while pneumonia is the most important cause of these fatalities. This research was carried out to find out what effects does a breathing exercise have on the respiratory functions and the improvement in the quality of life. The study was carried out for male patients suffering cervical spinal cord injuries for the purpose of inspiratory muscle strengthening. The objects of the study were 17 non-smoking-at-present male patients with C4 to C6 cervical spinal cord injuries. They had practiced inspiratory muscle strengthening training for three times a week for six weeks. The quality of life and the dyspnea (breathing difficulty) were self-measured before and after the training. As a result, the change in respiratory function was only significantly reduced (p<0.01) within the chronic group. In terms of the changes in the quality of life, the sub-acute group has only seen a significant improvement (p<0.05) for the VT(vitality), while the chronic group has seen significant improvements(p<0.05, p<0.01) in: GH(general health); BP(back pain); and VT(vitality). In this research, the inspiratory muscle strengthening has reduced the dyspnea (breathing difficulties) and improved the quality of life.

A Thoracolumbar Pure Spinal Epidural Cavernous Hemangioma - A Case Report - (흉요추부에서 발견된 경막외 해면상 혈관종 - 증례 보고 -)

  • Choi, Byeong Sam;Kim, Ju Yeon;Lee, Sungjoon
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.169-174
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    • 2018
  • Study Design: Case report. Objectives: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). Summary of Literature Review: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. Materials and Methods: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a $2.0{\times}0.5cm$ elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. Results: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. Conclusion: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.